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Effectiveness of the association between carbamazepine and peripheral analgesic block with ropivacaine for the treatment of trigeminal neuralgia

2010Journal article Open access
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dc.contributor.authorLemos, L
dc.contributor.authorFontes, R
dc.contributor.authorFlores, S
dc.contributor.authorOliveira, P
dc.contributor.authorAlmeida, A
dc.date.accessioned2012-02-08T15:14:59Z
dc.date.available2012-02-08T15:14:59Z
dc.date.issued2010
dc.description.abstractTreatment of trigeminal neuralgia (TN) is achieved by using adjuvant analgesics like antiepileptics, with carbamazepine (CBZ) being the first-line approach for TN patients, although side effects may be present. Other approaches using gabapentin, namely when associated with peripheral analgesic block of TN trigger points with the local anesthetic ropivacaine (ROP), resulted in decreased pain and daily drug intake (reduced side effects). This study evaluates if the association between CBZ and the peripheral block with ROP reinforces the clinical value of CBZ. In this parallel, double-blinded study, idiopathic TN patients were randomized to receive during 4 weeks either CBZ (CBZ; n = 21) or CBZ associated with the peripheral analgesic block using ROP (CBZ + ROP; n = 24). The primary outcome measures were the following: i) pain intensity, evaluated by the numerical rating scale; ii) number of pain crises; and iii) number needed to treat. Evaluation points were at the beginning (day 1) and end (day 29) of treatment and after a follow-up of 5 months (month 6). Both protocols resulted in a decrease of pain intensity and number of pain crises, but only the association CBZ + ROP showed i) a significant stronger reduction in pain intensity at month 6 and ii) a significant decrease in the daily dose of CBZ given to patients (both at day 29 and month 6). In contrast, the daily dose in CBZ-only patients remained constant or even increased. The number needed to treat for the association CBZ + ROP over the CBZ protocol reduced from 5 at the end of the 4-week treatment to 3 after the 5-month follow-up. Data reinforce the use of CBZ as a primary tool to control pain in TN patients, as the association CBZ + ROP i) improves the clinical qualities of CBZ, ii) strongly reduces the daily dose of CBZ, and iii) reduces the potential side effects attributed to high doses of CBZ.por
dc.identifier.citationJ Pain Res. 2010 25;3:201-12.por
dc.identifier.urihttp://hdl.handle.net/10400.23/137
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherDove Presspor
dc.subjectNevralgia do Trigémeopor
dc.subjectCarbamazepinapor
dc.subjectRopivacaínapor
dc.subjectBloqueio de Nervopor
dc.subjectAnestésicos Locaispor
dc.titleEffectiveness of the association between carbamazepine and peripheral analgesic block with ropivacaine for the treatment of trigeminal neuralgiapor
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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